Provider Demographics
NPI:1932798634
Name:SULLINGER, ALYSSA LEE
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LEE
Last Name:SULLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LONGFELLOW DR APT E
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-2829
Mailing Address - Country:US
Mailing Address - Phone:724-255-8066
Mailing Address - Fax:
Practice Address - Street 1:1803 WEST ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-2572
Practice Address - Country:US
Practice Address - Phone:724-255-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional